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I had a stroke and one of my carotid arteries is closed. How can I best prevent another stroke?

Question:

I had a stroke and then found out I have a 100% clogged internal right artery and a less than 50% clogged left artery. Was told cannot do surgery on right artery. What can be done to keep from having another stroke. I am on atorvastatin and 81 mg aspirin daily with blood pressure med.

Answer:

It is correct that when a carotid artery becomes 100% blocked, the artery cannot be reopened or bypassed. There is, however, some good news about that situation. Once a carotid artery is completely closed, the plaque in that artery will almost never embolize to the brain. In effect, therefore, that artery is usually thought to no longer represent any danger or threat. In terms of preventing another stroke from either the other carotid artery or from arteries inside the brain, the most important things to do are to treat high cholesterol and high blood pressure and keep the blood a bit “thin” by taking aspirin (unless there is a medical reason to avoid aspirin such as a history of a stomach ulcer). I recommend to my patients that they have a follow-up carotid ultrasound examination of the other artery (the one with less than 50% blockage) every six months. If the “good artery” begins to close significantly (80% or more), it may require surgery to clear the plaque out and prevent closure of that artery due to plaque accumulation.